Pelletier worked as an emergency medical technician for the defendant Liberty Ambulance Service. He claims that the defendants routinely “omitted and/or misrepresented the medical condition of the patient being transported… on the certificate of medical necessity.” This, he claims, allowed Liberty Ambulance Services to bill Medicare and Medicaid at a higher rate and allowed the hospital defendants to “discharge and transport patients without costs.” He is asking that the Court impose damages in the amount of “three times the damages to the Federal Government and civil penalties of no more than Eleven Thousand Dollars ($11,000.00) and no less than Five Thousand Dollars ($5,000.00) for each false claim[.]” These damages are provided by statute. The government will receive the majority of this money, but Pelletier, as the relator, will receive between 15 and 25 percent of that award.

According to a notice by the government, also unsealed today (which can be read here), the government has reached a settlement with the defendant hospitals, but no settlement has been reached with Liberty Ambulance Service and the government is intervening in the case against Liberty.

Qui Tam and False Claims Act lawsuits are complex matters that require an in-depth knowledge of Medicare and Medicaid along with the specific provisions of the False Claims Act. If you have been notified by the government that you are under investigation for a violation of the False Claims Act, you need experienced and knowledgeable attorneys protecting your rights. At Smith & Associates, we understand Medicare and Medicaid billing and the requirements imposed on healthcare providers. Our experienced litigators will fight aggressively for you.

If you are an employee in the health care industry and you are aware of improper government billing, our experienced healthcare attorneys can help you evaluate your claim and help you receive between 15 and 25% of any recovery the government obtains.